Project Summary Nebraska (NE) PRAMS has collected high scientific quality, population-based data on topics related to experiences before, during, and after pregnancy since 1999. PRAMS complements the vital records database adding nuances that only self-reported data can do. The following shows examples of issues that need to be addressed to improve the health of mothers and babies in Nebraska. Rates of infant mortality in Nebraska are significantly worse in some racial/ethnic groups (Black, American Indian, Hispanic and Mexican) are considerably higher than the Healthy People (HP) 2020 goal of 6.0 infants per 1,000 live births. Prenatal care initiated during the first trimester of pregnancy for all racial/ethnic groups are below the HP 2020 goal of 77.9%. Nebraska's racial and ethnic diversity has increased over the past decade and most of the growth in the state's population is projected to come from the young minority population. NE PRAMS stratifies by race/ethnicity and will continue to provide data to plan strategies to address these issues and for evaluation. Up to three self-administered questionnaires are mailed to sampled mothers. Mothers, who do not respond to any of the mailings, are followed up by telephone and encouraged to complete a telephone interview. Overall response rates have always been higher than the required CDC response rate threshold. NE PRAMS continues to develop methods to increase our response rates with the Black and American Indian populations that have consistently had lower response rates, due to locating them than actual refusals. This includes expanding sources to locate current phone numbers and addresses, and offering different rewards/incentives in the questionnaire packets. PRAMS information is provided in prenatal and postpartum hospital packets and during exhibits at health fairs to communicate the importance of completing the PRAMS questionnaire. NE PRAMS continues to be vital in planning, implementing and evaluating programs in the Nebraska Department of Health and Human Services (NDHHS) Maternal and Child Health (MCH) programs. NE PRAMS data is utilized for reports;to develop brochures, posters, press releases, fact sheets, and data books by many NDHHS programs, local health departments, and community health organizations. NE PRAMS will continue to produce fact sheets, data reports, completing data requests and collaborating on projects with statewide public health programs.